As per the guidelines published by the American Heart Association and published inHypertension in patients with resistant hypertension, the blood pressure remains above the target level despite taking three medications to lower it. High blood pressure that’s under control but requires four or more medications to treat it, is also considered resistant to treatment.
As many as 25 to 30% people with high blood pressure may have resistant hypertension inIndia.
Older age and obesity are two major risk factors for the condition. People with resistant hypertension have a high cardiovascular risk.
Successful treatment of resistant hypertension requires consideration of lifestyle factors, diagnosing and treating secondary causes, and using multiple drug treatments effectively.
Lifestyle factors include weight, salt intake and alcohol consumption.
1. Losing weight can lower blood pressure and reduce the number of medications needed to control blood pressure.
2. Reducing salt intake can lower blood pressure.
3. Reducing alcohol consumption can help lower blood pressure.
Health conditions that can contribute to resistant hypertension include: obstructive sleep apnea, renal parenchymal disease, primary aldosteronism and renal artery stenosis. Treating these conditions may improve blood pressure control.
Drugs that increase blood pressure, such as non-steroidal anti-inflammatory drugs (NSAIDs), should be reduced or halted, if possible, in patients with resistant hypertension.
Diuretics are often underused in people with resistant hypertension. Patients may benefit from adding mineralocorticoid receptor antagonists (MRAs) to their treatment regimens. MRAs treat primary aldosteronism, which is found in about 20 percent of people with resistant hypertension.
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